视黄醇结合蛋白4评价冠状动脉病变严重程度的研究  

Retinol binding protein 4 and the severity of coronary artery disease

作　　者：王潇[1] 王琳琳 常程 张新鑫 李晓东[1] WANG Xiao;WANG Lin-lin;CHANG Cheng;ZHANG Xin-xin;LI Xiao-dong(Department of Cardiovascular Medicine,Sheng/ing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院第一心血管内科,辽宁省沈阳市110004

出　　处：《中国心血管病研究》2020年第3期197-202,共6页Chinese Journal of Cardiovascular Research

基　　金："十二五"国家科技支撑计划(2014BAL11B04)。

摘　　要：目的 探究视黄醇结合蛋白4(retinol binding protein 4,RBP4)评价冠心病(coronary heart disease,CHD)患者冠状动脉病变的严重程度.方法 选取2018年12月至2019年8月于中国医科大学附属盛京医院行冠状动脉造影的患者202例,根据冠状动脉造影结果将患者分为冠心病组(159例)及正常组(43例);其中,根据诊断将冠心病组分为急性ST段抬高型心肌梗死组(36例)、急性非ST段抬高型心肌梗死组(35例)和心绞痛组(88例).采用SYNTAX评分评估冠状动脉病变的严重程度,并收集患者血液样本,检测血清RBP4水平,分析比较各组SYNTAX评分与RBP4水平的相关性.用Pearson相关分析方法分析RBP4水平与SYNTAX评分的相关性;应用ROC曲线评估RBP4水平预测重度冠状动脉病变的最佳切点.结果 冠心病组RBP4水平显著高于正常组[(42.51±19.00)ng/ml比(36.44±11.13)ng/ml],差异具有统计学意义(P<0.05);其中,急性ST段抬高型心肌梗死组、急性非ST段抬高型心肌梗死组RBP4水平显著高于正常组[(47.82±29.98)ng/ml、(44.82±15.23)ng/ml比(36.44±11.13)ng/ml],差异具有统计学意义(P<0.05);心绞痛组[(39.42±21.43)ng/ml]与正常组[(36.44±11.13)ng/ml]之间差异无统计学意义(P>0.05);急性ST段抬高型心肌梗死组RBP4水平显著高于心绞痛组[(47.82±29.98)ng/ml比(39.42±21.43)ng/ml](P<0.05);冠心病组患者RBP4水平与SYNTAX评分呈正相关(r=0.412,P<0.001).ROC曲线分析结果提示,RBP4预测重度冠状动脉病变的最佳切点是33.37ng/ml,敏感度为0.76,特异度为0.49.结论 冠心病患者RBP4水平较正常人显著升高,RBP4与冠状动脉病变严重程度呈正相关,当RBP4>33.37ng/ml,可能存在重度冠状动脉病变风险.Objective To investigate the relation between retinol binding protein 4(RBP4)and the severity of coronary artery disease in patients with coronary heart disease.Methods 202 patients once underwent coronary angiography in China Medical University Affiliated Shengjing Hospital from December,2018 to August,2019 were enrolled.According to the results of coronary angiography,they were divided into coronary heart disease group(159 cases)and control group(43 cases).The coronary artery disease group was divided into acute ST-segment elevated myocardial infarction group,acute non-ST-segment elevation myocardial infarction group and angina pectoris group.SYNTAX score was used to evaluate the severity of coronary artery disease and its relationship with RBP4 was analyze.Pearson correlation analysis was used to analyze the correlation between the level of RBP4 and SYNTAX score.The ROC curve was used to evaluate the optimal cut-off point of RBP4 level in predicting severe coronary artery disease.Results The RBP4 value of CHD group was significantly higher than that of normal group(42.51±19.00)ng/ml vs.(36.44±11.13)ng/ml j.The RBP4 value of acute ST segment elevated myocardial infarction group and acute non-ST segment elevated myocardial infarction group were significantly higher than that of normal group(47.82±29.98)ng/ml,(44.82±15.23)ng/ml vs.(36.44±11.13)ng/ml j,while there is no significant difference between the angina pectoris group and the normal group.The difference between the acute ST segment elevated myocardial infarction group and the angina pectoris group was also obvious(P<0.05),while the difference between the acute ST segment elevated myocardial infarction group and acute non-ST segment elevated myocardial infarction group was also not obvious[(47.82±29.98)ng/ml vs.(39.42±21.43)ng/ml.There was a significant positive relationship between RBP4 and SYNTAX score(r=0.412,PvO.OOl).The result of ROC curve analysis suggested that the best cut-point of RBP4 level in predicting severe coronary artery disease was 3

关 键 词：视黄醇结合蛋白4 冠状动脉疾病 SYNTAX评分 

分 类 号：R541.4[医药卫生—心血管疾病]